In the field of anastomoses between body ducts, a first solution consists of directly connecting the ducts with the aid of manual surgical sutures. This solution has the sole advantage of not requiring any devices. However, the time necessary for performing it is relatively long and the quality of the junction depends on the dexterity of the practitioner in connecting two flexible ducts.
Another solution consists of utilizing a tubular prosthesis in the form of a sleeve whose two ends are intubed respectively in the two ducts to be connected with means provided for interlocking the intubed parts of the prosthesis and the end portions of said ducts.
Document WO 98/19631 discloses an anastomosis device of the above type composed of a prosthesis formed from an expandable mesh structure whose intubed extremities in the ducts to be joined are equipped with means for anchoring them to the end portions of said ducts. For that purpose, each end of the prosthesis is composed of a special auto-expandable structure equipped with radial projections designed to penetrate the tissue of the ducts in order to prevent any slippage between said ducts and the prosthesis.
Such a device is not completely satisfactory. Firstly, because it requires that a special prosthesis be made since it incorporates distinctive structures at each extremity. Secondly, because the prosthesis cannot be set in place with the aid of a balloon catheter and the intubed parts of the prosthesis are pressed against the end portions of the ducts simply by auto-expansion, this technique does not assure a truly firm and impervious anchoring.
Additionally, document U.S. Pat. No. 4,214,587 discloses a two-vessel anastomosis device assisted by a radially resilient cylindrical spring equipped externally with barbs. This component has to be compressed to reduce its diameter in order for it to be introduced into the end portion of the duct to be anastomosed. Once released, it expands to assume its nominal diameter.
In addition, there is the disadvantage of a means of anchoring that is not guaranteed to be truly firm and impervious as in the preceding case, with the annular component ceasing to expand while the intubed portion may not be pressed completely against the end part of the duct to be joined. Such a component is necessarily dimensioned for an area of very reduced diameters in ducts to be anastomosed, thus necessitating the creation of a range of annular components of various diameters and a precise choice of the most suitable component for each anastomosis.
Finally, documents U.S. Pat. No. 5,931,842 and WO 98/19634 disclose systems intended to create anastomoses, but within the specific framework of cardiac bypasses, that is, end-side anastomosis assisted by expandable rings equipped externally with barbs, but with no details given as to the structure of the ring and arrangement of the barbs.
The aim of the present invention is to overcome the disadvantages of the known anastomosis systems and, in particular, to offer a device specifically adapted to end-to-end anastomoses.